Review of MRI imaging for placenta accreta spectrum: Pathophysiologic insights, imaging signs, and recent developments

Kapoor, Harit; Hanaoka, Mauro; Dawkins, Adrian; Khurana, Aman

doi:10.1016/j.placenta.2020.11.004

Cited by 47 publications

(65 citation statements)

References 49 publications

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“…MRI is more accurate than ultrasound in diagnosing the depth and topography of PAS (24). However, MRI is more expensive and has complex imaging principles (25), which limit its general applicability. Nowadays, the researchers try to find biochemical markers of PAS, which may be potential markers for the diagnosis of the severity of PAS.…”

Section: Discussionmentioning

confidence: 99%

Developing and Validating Nomogram to Predict Severe Postpartum Hemorrhage in Women With Placenta Previa Undergoing Cesarean Delivery: A Multicenter Retrospective Case-Control Study

et al. 2022

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ObjectiveDeveloping and validating nomogram to predict severe postpartum hemorrhage (SPPH) in women with placenta previa (PP) undergoing cesarean delivery.MethodsWe conducted a multicenter retrospective case-control study in five hospitals. In this study, 865 patients from January, 2018 to June, 2020 were enrolled in the development cohort, and 307 patients from July, 2020 to June, 2021 were enrolled in the validation cohort. Independent risk factors for SPPH were obtained by using the multivariate logistic regression, and preoperative nomogram and intraoperative nomogram were developed, respectively. We compared the discrimination, calibration, and net benefit of the two nomograms in the development cohort and validation cohort. Then, we tested whether the intraoperative nomogram could be used before operation.ResultsThere were 204 patients (23.58%) in development cohort and 80 patients (26.06%) in validation cohort experienced SPPH. In development cohort, the areas under the receiver operating characteristic (ROC) curve (AUC) of the preoperative nomogram and intraoperative nomogram were 0.831 (95% CI, 0.804, 0.855) and 0.880 (95% CI, 0.854, 0.905), respectively. In validation cohort, the AUC of the preoperative nomogram and intraoperative nomogram were 0.825 (95% CI, 0.772, 0.877) and 0.853 (95% CI, 0.808, 0.898), respectively. In the validation cohort, the AUC was 0.839 (95% CI, 0.789, 0.888) when the intraoperative nomogram was used before operation.ConclusionWe developed the preoperative nomogram and intraoperative nomogram to predict the risk of SPPH in women with PP undergoing cesarean delivery. By comparing the discrimination, calibration, and net benefit of the two nomograms in the development cohort and validation cohort, we think that the intraoperative nomogram performed better. Moreover, application of the intraoperative nomogram before operation can still achieve good prediction effect, which can be improved if the severity of placenta accreta spectrum (PAS) can be accurately distinguished preoperatively. We expect to conduct further prospective external validation studies on the intraoperative nomogram to evaluate its application value.

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Section: Discussionmentioning

confidence: 99%

Developing and Validating Nomogram to Predict Severe Postpartum Hemorrhage in Women With Placenta Previa Undergoing Cesarean Delivery: A Multicenter Retrospective Case-Control Study

et al. 2022

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“…Studies comparing the diagnostic accuracy of ultrasound imaging with that of MRI in diagnosing placenta accreta are inevitably biased towards MRI, as only suspected cases of PAS on ultrasound scan are subjected to MRI examination 44,45 . Gadolinium-based MRI contrast improves visualization of the uteroplacental vasculature, but the agents cross the placental-fetal barrier and, therefore, its use is not recommended during pregnancy 40,41,48 . Overall, national and international guidelines have concluded that, given its high cost and limited clinical value, MRI should not be used routinely as an adjunct to ultrasound in the routine diagnosis of PAS 31,40,48 .…”

Section: Prenatal Imaging Diagnosis Of Pasmentioning

confidence: 99%

Debunking 20^th century myths and legends about the diagnosis of placenta accreta spectrum

Jauniaux

Hussein

Einerson

et al. 2022

Ultrasound in Obstet & Gyne

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“…A study reported that MRI can help diagnose late pregnancy bleeding, including placental abruption 18 . Among them, the most common use for placental MRI is to assess for placental accreta spectrum in clinical settings 19 . Placental abruption often causes fetal acidosis and hypoxia, which is related to placental insufficiency and ischemia.…”

Section: Introductionmentioning

confidence: 99%

“…18 Among them, the most common use for placental MRI is to assess for placental accreta spectrum in clinical settings. 19 Placental abruption often causes fetal acidosis and hypoxia, which is related to placental insufficiency and ischemia. However, no studies have antenatally evaluated the quantitative values of placental ischemia using ADC values during the expectant management of placental abruption.…”

Section: Introductionmentioning

confidence: 99%

Assessment of placental abruption with diffusion‐weighted imaging

Mizutani

Kotani

Kato

et al. 2022

J of Obstet and Gynaecol

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Aim: To investigate whether placental abruption without fetal distress could be assessed by apparent diffusion coefficient (ADC) values in magnetic resonance imaging (MRI). Methods: We conducted a retrospective case-control study at a single center. ADC values at the lesions of placental abruption in the abruption group (n = 8) were compared to those in the control group (n = 32). In the abruption group, ADC values at the sites of abruption were also compared to those at the nonabruption sites within the same placenta. Results: The ADC values in the placental area above the abruption site in the abruption group showed lower values than those in the control group when the slice containing the umbilical cord insertion site was set as the reference, and those values were compared in each corresponding slice. Compared with average ADC values, those above the abruption site in the abruption group were also significantly lower than those in the control group (p < 0.001). Furthermore, ADC values at the area above abruption were lower than those at the nonabruption area of all planes in the abruption group. Conclusions: ADC values at the lesions above the placental abruption site were reduced compared to those in the normal placenta and those in the nonabruption area. Thus, it would be helpful to understand the pathophysiology of placental abruption in expectant management, although further investigations would be needed.

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Review of MRI imaging for placenta accreta spectrum: Pathophysiologic insights, imaging signs, and recent developments

Cited by 47 publications

References 49 publications

Developing and Validating Nomogram to Predict Severe Postpartum Hemorrhage in Women With Placenta Previa Undergoing Cesarean Delivery: A Multicenter Retrospective Case-Control Study

Developing and Validating Nomogram to Predict Severe Postpartum Hemorrhage in Women With Placenta Previa Undergoing Cesarean Delivery: A Multicenter Retrospective Case-Control Study

Debunking 20^th century myths and legends about the diagnosis of placenta accreta spectrum

Assessment of placental abruption with diffusion‐weighted imaging

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Review of MRI imaging for placenta accreta spectrum: Pathophysiologic insights, imaging signs, and recent developments

Cited by 47 publications

References 49 publications

Developing and Validating Nomogram to Predict Severe Postpartum Hemorrhage in Women With Placenta Previa Undergoing Cesarean Delivery: A Multicenter Retrospective Case-Control Study

Developing and Validating Nomogram to Predict Severe Postpartum Hemorrhage in Women With Placenta Previa Undergoing Cesarean Delivery: A Multicenter Retrospective Case-Control Study

Debunking 20th century myths and legends about the diagnosis of placenta accreta spectrum

Assessment of placental abruption with diffusion‐weighted imaging

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Debunking 20^th century myths and legends about the diagnosis of placenta accreta spectrum